Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study

Xu, Jianwei; Xu, Qi-Zhang; Liu, Hui; Zeng, Yi-Rou

doi:10.1186/1475-2875-11-417

Cited by 71 publications

(106 citation statements)

References 10 publications

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“…A large proportion of the children with fever were brought to treatment, which is consistent with a study in Myanmar [26]. While early detection and access to prompt treatment is regarded as the corner stone of a successful malaria control strategy, however, most children sought treatment after 24 h of onset of fever, thus, in the late stage of the disease.…”

Section: Discussionsupporting

confidence: 81%

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Caregivers’ perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study

Mitiku

Assefa

2017

Malar J

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BackgroundEarly diagnosis and prompt malaria treatment is essential to reduce progression of the illness to severe disease and, therefore, decrease mortality particularly among children under 5 years of age. This study assessed perception of malaria and treatment-seeking behaviour for children under five with fever in the last 2 weeks in Mandura District, West Ethiopia.MethodsA community based cross-sectional study was conducted among 491 caregivers of children under five in Mandura District, West Ethiopia in December 2014. Data were collected using interviewer-administered questionnaires. Data were entered into Epi Info version 7 and analysed using SPSS version 20. Multiple logistic regression analyses were conducted to identify the determinants of caregivers’ treatment-seeking behaviour.ResultsOverall, 94.1% of the respondents perceived that fever is the most common symptom and 70% associated mosquito bite with the occurrence of malaria. Of 197 caregivers with under five children with fever in the last 2 weeks preceding the study 87.8% sought treatment. However, only 38.7% received treatment within 24 h of onset of fever. Determinants of treatment-seeking include place of residence (rural/urban) (AOR 2.80, 95% CI 1.01–7.70), caregivers age (AOR 3.40, 95% CI 1.27–9.10), knowledge of malaria (AOR 4.65, 95% CI 1.38–15.64), perceived susceptibility to malaria (AOR 3.63, 95% CI 1.21–10.88), and perceived barrier to seek treatment (AOR 0.18, 95% CI 0.06–0.52).ConclusionsMajority of the respondents of this study sought treatment for their under five children. However, a considerable number of caregivers first consulted traditional healers and tried home treatment, thus, sought treatment late. Living in rural village, caregivers’ age, malaria knowledge, perceived susceptibility to malaria and perceived barrier to seek treatment were important factors in seeking health care. There is a need to focus on targeted interventions, promote awareness and prevention, and address misconceptions about childhood febrile illness.

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Section: Discussionsupporting

confidence: 81%

“…However, only 45% of the participants had sufficient knowledge about malaria. This finding indicates the need to enhance caregivers’ malaria knowledge as it has also been reported to influence treatment-seeking behaviour [26]. …”

Section: Discussionmentioning

confidence: 98%

Caregivers’ perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study

Mitiku

Assefa

2017

Malar J

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“…Moreover, Cambodian patients frequently buy drugs from market stalls and village drug shops [17, 18], a common practice seen in other malaria-endemic countries [19, 20]. The PQ dosing conundrum is not new and one solution is to design easy to use, optimised, age-based dosing regimens, as has been done for artesunate-amodiaquine [21], artesunate-mefloquine, and DHAPP.…”

Section: Introductionmentioning

confidence: 99%

An optimised age-based dosing regimen for single low-dose primaquine for blocking malaria transmission in Cambodia

Leang

Khu

Mukaka

et al. 2016

BMC Med

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BackgroundIn 2012, the World Health Organization recommended the addition of single low-dose primaquine (SLDPQ, 0.25 mg base/kg body weight) to artemisinin combination therapies to block the transmission of Plasmodium falciparum without testing for glucose-6-phosphate dehydrogenase deficiency. The targeted group was non-pregnant patients aged ≥ 1 year (later changed to ≥ 6 months) with acute uncomplicated falciparum malaria, primarily in countries with artemisinin-resistant P. falciparum (ARPf). No dosing regimen was suggested, leaving malaria control programmes and clinicians in limbo. Therefore, we designed a user-friendly, age-based SLDPQ regimen for Cambodia, the country most affected by ARPf.MethodsBy reviewing primaquine’s pharmacology, we defined a therapeutic dose range of 0.15–0.38 mg base/kg (9–22.5 mg in a 60-kg adult) for a therapeutic index of 2.5. Primaquine doses (1–20 mg) were tested using a modelled, anthropometric database of 28,138 Cambodian individuals (22,772 healthy, 4119 with malaria and 1247 with other infections); age distributions were: 0.5–4 years (20.0 %, n = 5640), 5–12 years (9.1 %, n = 2559), 13–17 years (9.1 %, n = 2550), and ≥ 18 years (61.8 %, n = 17,389). Optimal age-dosing groups were selected according to calculated mg base/kg doses and proportions of individuals receiving a therapeutic dose.ResultsFour age-dosing bands were defined: (1) 0.5–4 years, (2) 5–9 years, (3) 10–14 years, and (4) ≥15 years to receive 2.5, 5, 7.5, and 15 mg of primaquine base, resulting in therapeutic doses in 97.4 % (5494/5640), 90.5 % (1511/1669), 97.7 % (1473/1508), and 95.7 % (18,489/19,321) of individuals, respectively. Corresponding median (1st–99th centiles) mg base/kg doses of primaquine were (1) 0.23 (0.15–0.38), (2) 0.29 (0.18–0.45), (3) 0.27 (0.15–0.39), and (4) 0.29 (0.20–0.42).ConclusionsThis age-based SLDPQ regimen could contribute substantially to malaria elimination and requires urgent evaluation in Cambodia and other countries with similar anthropometric characteristics. It guides primaquine manufacturers on suitable tablet strengths and doses for paediatric-friendly formulations. Development of similar age-based dosing recommendations for Africa is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0701-8) contains supplementary material, which is available to authorized users.

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“…Furthermore, studies in Myanmar and on the Thai-Cambodian border found that malaria treatment was often delayed in remote areas. 25,26 Because jhum cultivators often work in large groups at various phases of cultivation, lack of prompt malaria treatment may facilitate local malaria outbreaks that can later be spread when jhum cultivators return to their villages.…”

Section: Discussionmentioning

confidence: 99%

The Practice of Jhum Cultivation and its Relationship to Plasmodium falciparum Infection in the Chittagong Hill Districts of Bangladesh

Galagan¹,

Prue²,

Khyang³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Malaria is endemic in the Chittagong Hill Districts of southeastern Bangladesh. Previous epidemiological analyses identified the agricultural practice of jhum cultivation as a potential risk factor for malaria infection. We conducted qualitative interviews with jhum cultivators and surveillance workers to describe jhum cultivation and used demographic and malaria surveillance in two study unions from May of 2010 to August of 2012 to better understand the relationship between jhum cultivation and malaria infection. Qualitative interviews revealed that jhum cultivation is conducted on remote, steep hillsides by ethnic tribal groups. Quantitative analyses found that adult jhum cultivators and individuals who live in the same residence had significantly higher incidence rates of symptomatic Plasmodium falciparum infection compared with non-cultivators. These results confirm that jhum cultivation is an independent risk factor for malaria infection and underscore the need for malaria testing and treatment services to reach remote populations in the Chittagong Hill Districts. BACKGROUND

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Malaria treatment-seeking behaviour and related factors of Wa ethnic minority in Myanmar: a cross-sectional study

Cited by 71 publications

References 10 publications

Caregivers’ perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study

Caregivers’ perception of malaria and treatment-seeking behaviour for under five children in Mandura District, West Ethiopia: a cross-sectional study

An optimised age-based dosing regimen for single low-dose primaquine for blocking malaria transmission in Cambodia

The Practice of Jhum Cultivation and its Relationship to Plasmodium falciparum Infection in the Chittagong Hill Districts of Bangladesh

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